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About 1-2% of men who undergo vasectomy will have some degree of chronic pain. The majority of these men will have had traditional or conventional vasectomies, as no-scalpel no-needle vasectomies have a lower incidence of chronic pain. While most post-vasectomy pain is mild and self-limiting, about 1 in 1000 men who undergo vasectomy will have such severe pain that surgical measures might be considered. It’s unclear what causes this, but it’s most likely scarring and pulling from the vasectomy site to the surrounding muscle that moves and contracts with temperature. Occasionally the chronic pain can be from epididymitis or congestion of the epididymis. Reversing the vasectomy resolves or improves the pain in about 90% of cases, but a careful preoperative assessment of other causes of scrotal pain should be pursued before reversal is considered.